Prediction of cardiac events in patients with reduced left ventricular ejection fraction with dobutamine cardiovascular magnetic resonance assessment of wall motion score index.

Dall'Armellina E, Morgan TM, Mandapaka S, Ntim W, Carr JJ, Hamilton CA, Hoyle J, Clark H, Clark P, Link KM, Case D, Hundley WG
J Am Coll Cardiol. 2008 52 (4): 279-86

PMID: 18634983 · PMCID: PMC3666037 · DOI:10.1016/j.jacc.2008.04.025

OBJECTIVES - The purpose of this study was to assess the utility of dobutamine cardiovascular magnetic resonance (DCMR) results for predicting cardiac events in individuals with reduced left ventricular ejection fraction (LVEF).

BACKGROUND - It is unknown whether DCMR results identify a poor cardiac prognosis when the resting LVEF is moderately to severely reduced.

METHODS - Two hundred consecutive patients ages 30 to 88 (average 64) years with an LVEF
RESULTS - After accounting for risk factors associated with coronary arteriosclerosis and MI, a stress-induced increase in WMSI during DCMR was associated with future cardiac events (p < 0.001). A DCMR stress-induced change in WMSI added significantly to predicting future cardiac events (p = 0.003), after accounting for resting LVEF, but this predictive value was confined primarily to those with an LVEF >40%.

CONCLUSIONS - In individuals with mild to moderate reductions in LVEF (40% to 55%), dobutamine-induced increases in WMSI forecast MI and cardiac death to a greater extent than an assessment of resting LVEF. In those with an LVEF <40%, a dobutamine-induced increase in WMSI does not predict MI and cardiac death beyond the assessment of resting LVEF.

MeSH Terms (18)

Adult Aged Aged, 80 and over Angina, Unstable Echocardiography, Stress Female Heart Ventricles Hemodynamics Humans Magnetic Resonance Imaging Magnetic Resonance Imaging, Cine Male Middle Aged Myocardial Ischemia Prognosis Prospective Studies Risk Factors Stroke Volume

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